Veterans with serious disabilities should be aware that they might be entitled to higher rates of compensation above the schedular ratings that typically compensate for conditions or injuries up to 100 percent. The additional compensation is called Special Monthly Compensation (SMC) and is one of the more complicated areas of Veterans Law. Nevertheless, a basic understanding of SMC could result in higher compensation for veterans eligible to receive it.
About Special Monthly Compensation (SMC)
SMC is intended for veterans who have serious injuries, including injuries that result in (1) loss of use of function or by amputation of their upper or lower extremities, (2) loss of senses such as loss of eyesight or hearing or ability to speak, (3) loss of use of a creative organ, or (4) inability to attend to the wants of nature. There are also rules for statutory housebound based on the levels of combined ratings and for veterans in need of caregivers providing aid and attendance. While many of the provisions do not address mental health, veterans with mental health disabilities can access SMC if in need of aid and attendance or are housebound. There are also special provisions for Veterans with traumatic brain injuries (TBI).
Under the current ratings schedule, veterans who receive 100% disability rating receive $3,164 if single. With SMC, that veteran could receive rates that range from an additional $114 per month to maximum combined rates over $9,000 per month. Unlike typical service-connected disability compensation, SMC is not based upon reference to loss of earning capacity for employment but is based on the actual disability and its severity.
An important aspect of SMC to understand is that the VA is required to identify eligible veterans based on the levels of their disabilities. It is what is called an “inferred issue” which means the VA is obligated to make sure the veteran is awarded SMC if they qualify. However, veterans and their advocates should be assertive about their rights when it comes to receiving this additional compensation for their disabilities. This is complex and well-meaning VA employees often make mistakes in applying the regulations properly.
Basic levels of Special Monthly Compensation
The primary statute for SMC is found at 38 U.S. Code § 1114 or in the VA regulations at 38 C.F.R. § 3.350. The most basic SMC is found at 38 U.S. Code § 1114(k), which is often referred to as SMC-K by practitioners. This level of SMC typically must be satisfied before higher levels of compensation can be considered. Here are the conditions and levels for SMC-K, all found at 38 U.S. Code § 1114(k), 38 C.F.R. § 3.350.:
- Loss of use of creative organ. $111.74. This is not dependent on actual fertility but rather anatomical loss or loss of use.
- Loss of use of one hand. $111.74. *Note this is not amputation alone; it can simply involve the loss of use.
- Loss of use of one foot. $111.74. *Same as above; loss of use is key determinant.
- Loss of use of both buttocks. $111.74. These are important muscles in standing up and sitting down so any issues with these movements likely involve an issue with the muscles in the buttocks.
- Blindness of one eye. $111.74. This is referenced to corrected vision.
- Deafness of both ears. $111.74. This requires audiology assessment.
- Aphonia (loss of voice). $111.74.
- Loss of one or both breasts. $111.74. *This is for women; mastectomy would be the most common condition.
Statutory Housebound Eligibility
Some veterans may qualify for additional SMC because of their status as housebound. Keep in mind that this differs from aid and attendance, described below, and is sometimes referred to as statutory housebound. It is a matter of meeting the criteria at 38 U.S. Code § 1114(s) and might not require being housebound. Typically called SMC-S, the veteran needs to have (1) one service-connected disability rated at 100 percent, and (2) a second total disability that results (3) in a combined rating of 60% or higher. There is also a way to access SMC-S with TDIU if there is one disability that creates eligibility for TDIU.
An alternate path for housebound benefits is for the veteran to have a disability rated at 100% but actually be “substantially confined” to their dwelling or residence as a result of service-connected disabilities and demonstrate that it is reasonably certain that the disabilities will be present for the rest of their lifetime. Substantial confinement does not preclude the veteran from leaving the home for routine doctor’s appointments, for example.
Regular Aid and Attendance and Permanently Bedridden
Benefits for regular aid and attendance and permanently bedridden pay at higher rates and will require that the veteran is bedridden or that they require aid and attendance (A&A) of others to perform daily activities of life. This is also known as SMC-L and is appropriately found at 38 U.S. Code § 1114(l). This can be accessed if the veteran has combined rating of 100% and shows the need for A&A or a combined 100% for a “single disability” that includes a single disease process such as Parkinson’s or Diabetes even if there are multiple disabilities.
This is a higher standard than housebound, and the key factor is if the veteran must depend on another for simple tasks associated with daily living. It is also not as rigid in determination. For example, there are options for the VA to seek a higher-level advisory opinion if the veterans condition requires A&A despite not meeting the regulatory definitions for eligibility.
Special Aid and Attendance
Finally, the highest levels of SMC are found after earlier levels of SMC are satisfied and the veteran displays a higher level of injury or a need for regular or special A&A. The levels of SMC from (l) to (o) generally involve multiple losses or pairs of losses. For example, one might lose use of feet and hands on one side or both feet in combination or have blindness in both eyes. There are also intermediate rates and combinations of injuries whereby the veteran might receive a combination that results in SMC-L at one-half such as when there are varying degrees of blindness in each eye.
Special Aid and Attendance is found at 38 U.S. Code § 1114(r-1) and (r-2). The R-1 level is for special aid and attendance and requires being rated at SMC-L (§ 1114(l)) for regular aid and attendance and be rated at SMC-O at maximum or having (n) and (o) and (k) in combination. The R-2 level is for special aid and attendance for higher care. This requires daily assistance for personal heath services provided by healthcare professional or by under supervision of a health care professional.
Overall, veterans with serious injuries above the service-connected disability rating schedules may be eligible for higher levels of compensation if faced with some of the most daunting injuries incurred in service. The VA is obligated to evaluate their eligibility for SMC when preliminary indications support their entitlement to it. Nevertheless, veterans and advocates need to be proactive to make sure that their serious conditions are not overlooked for SMC. In that case, a little bit of knowledge on basic SMC can go a long way.